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All Charges

Charge Type Setting Price  
Service Code ICD 047B3DZ
Hospital Charge Code 4273
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047B3EZ
Hospital Charge Code 4274
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047B3FZ
Hospital Charge Code 4275
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047B3GZ
Hospital Charge Code 4276
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047B441
Hospital Charge Code 2117
Min. Negotiated Rate $8,623.00
Max. Negotiated Rate $8,623.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,623.00
Service Code ICD 047B44Z
Hospital Charge Code 2118
Min. Negotiated Rate $8,623.00
Max. Negotiated Rate $8,623.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,623.00
Service Code ICD 047B45Z
Hospital Charge Code 2119
Min. Negotiated Rate $8,623.00
Max. Negotiated Rate $8,623.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,623.00
Service Code ICD 047B46Z
Hospital Charge Code 2120
Min. Negotiated Rate $8,623.00
Max. Negotiated Rate $8,623.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,623.00
Service Code ICD 047B47Z
Hospital Charge Code 2121
Min. Negotiated Rate $8,623.00
Max. Negotiated Rate $8,623.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,623.00
Service Code ICD 047B4D1
Hospital Charge Code 4277
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047B4D6
Hospital Charge Code 4278
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047B4DZ
Hospital Charge Code 4279
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047B4EZ
Hospital Charge Code 4280
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047B4FZ
Hospital Charge Code 4281
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047B4GZ
Hospital Charge Code 4282
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047C041
Hospital Charge Code 2122
Min. Negotiated Rate $8,623.00
Max. Negotiated Rate $8,623.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,623.00
Service Code ICD 047C04Z
Hospital Charge Code 2123
Min. Negotiated Rate $8,623.00
Max. Negotiated Rate $8,623.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,623.00
Service Code ICD 047C05Z
Hospital Charge Code 2124
Min. Negotiated Rate $8,623.00
Max. Negotiated Rate $8,623.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,623.00
Service Code ICD 047C06Z
Hospital Charge Code 2125
Min. Negotiated Rate $8,623.00
Max. Negotiated Rate $8,623.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,623.00
Service Code ICD 047C07Z
Hospital Charge Code 2126
Min. Negotiated Rate $8,623.00
Max. Negotiated Rate $8,623.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,623.00
Service Code ICD 047C0D1
Hospital Charge Code 4283
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047C0D6
Hospital Charge Code 4284
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047C0DZ
Hospital Charge Code 4285
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047C0EZ
Hospital Charge Code 4286
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00
Service Code ICD 047C0FZ
Hospital Charge Code 4287
Min. Negotiated Rate $3,913.00
Max. Negotiated Rate $3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,913.00